Trigger PointsTrigger Point Injections (TPI) are medications administered to relax tender and tight clusters of muscle known as trigger points.
Trigger points consist of many sensitive spots in various parts of the body. These injections only require minimal invasion to the body.

The doctor first gives the patient an injection of painkillers known as Marcaine to the affected area. The common areas of the body affected by trigger point muscle pain are the lower back, neck, arms, or legs.

Some common side effects include injection site bleeding, worsening of pain, and nerve damage. TPI can also be used to treat Fibromyalgia and tension headaches.

Research on Trigger Points

Patients evaluated in one pain management center were found to have a myofascial component to their pain in 95% of cases (Gerwin RD. A study of 96 subjects examined for both fibromyalgia and myofascial pain. J Musculoskeletal Pain 1995; 3 (suppl. 1):121-5.).  

There is increasing awareness that active myofascial trigger points often play a role in the symptoms of patients with tension headaches (Fernandez-de-Las-Penas C, onso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Myofascial trigger points and their relationship to a headache clinical parameters in chronic tension-type headache. A headache 2006; 46(8):1264-72.), low back pain, neck pain (Fernandez-de-Las-Penas C, onso-Blanco C, Miangolarra JC. Myofascial trigger points in subjects presenting with mechanical neck pain:

A blinded, controlled study. Man Ther 2006; ), temporomandibular pain, forearm and hand pain, postural pain (Treaster D, Marras WS, Burr D, Sheedy JE, Hart D. Myofascial trigger point development from visual and postural stressors during computer work. J Electromyogr Kinesiol 2005;), pelvic/urogenital pain syndromes.

As a result, the damage to muscle and connective tissue which results in trigger points can occur several ways. It can happen as the result of:

  • First Repetitive overuse injuries (using the same body parts, in the same way, hundreds of times on a daily basis) from activities such as typing/mousing, handheld electronics, gardening, home improvement projects, work environments, etc.
  • Consequently sustained loading as with heavy lifting, carrying babies, briefcases, boxes, wearing body armor or lifting bedridden patients.
  • Habitually poor posture due to our sedentary lifestyles, de-conditioning, and poorly designed furniture
  • Muscle clenching and tensing due to mental/emotional stress.
  • A direct injury such as a blow, strain, break, twist or tear. Think car accidents, sports injuries, falling down stairs and the like.
  • Finally, trigger points can even develop due to inactivities such as prolonged bed rest or sitting.